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World health – World AIDS Day (1st December 2022)

Today, World AIDS Day, France is reiterating its unwavering commitment to this fight. The French President provided further proof of this commitment when he announced last September that France will be making an unprecedented contribution of over €1.6 billion to the Global Fund to Fight AIDS, (…)

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France, a major global health player

To overcome major health challenges at the international level, France defends an approach based on principles, solidarity and human rights, in line with the World Health Organization’s definition of health: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”

As such, France is financially committed and takes concrete action to reduce inequality in healthcare, ensure everyone has equal access to healthcare treatments and foster inclusion of vulnerable groups and those in the margins of society.

Global healthcare is a priority of France’s international development policy. Its action to promote healthcare is reflected in a number of financial and political commitments in international organizations and programmes.

France’s 2017-2021 Global Health Strategy

France adopted a Global Health Strategy for the years 2017 to 2021. This strategy is the result of work undertaken with all French healthcare, research and development stakeholders.
It is based on a cross-cutting approach to the challenges of global health and has four major priorities:
1. Enhancing health systems while fighting illnesses;
2. Enhancing health security at the international level;
3. Promoting the health of populations;
4. Promoting French expertise, training, research and innovation.

Fundamental principles guide France’s action:

  • a rights-based approach,
  • the promotion of health on a universal scale, especially by fighting all forms of inequality,
  • ownership by countries,
  • French attractiveness and influence, in particular in terms of training, research and innovation in healthcare.

Considerable health challenges persist

Life expectancy in the world rose by five years between 2000 and 2015, the fastest rise since the 1960s. Despite this progress, significant disparities persist.

While almost 26 million people had access to antiretrovirals (compared to just 7.5 million 10 years ago), in 2019, 1.7 million people were infected by HIV and 700,000 died of the disease. The same year, tuberculosis infected 10 million people and killed 1.4 million, and malaria caused almost 400,000 deaths.

The fight against infant and child mortality made great progress between 1990 and 2018, with more than a 50% decrease in the mortality rate of children under the age of five. However, this progress hides great regional disparities: two regions (sub-Saharan Africa and Central and South Asia) represented more than 80% of the 5.2 million deaths among children under the age of five in 2019.
The same goes for maternity care: around the world, the number of women who die during pregnancy or in childbirth decreased by 38% between 2000 and 2017. However, 810 women die every day of avoidable causes during pregnancy or in childbirth, and 94% of them live in low- or middle-income countries.

The figures indicated in this paragraph were sourced from UNAIDS, WHO and the French Muskoka Fund.

An estimated 200 million women or more around the world would like to avoid pregnancy but have no access to contraception. Every year, 80 million undesired pregnancies result in 25 million unsafe abortions, endangering the lives of women and girls.

Almost half of the world’s population are living without any form of health coverage against risks of disease. Every year, more than 100 million people struggle in extreme poverty caused by healthcare costs left at their expense.

Fighting major pandemics

France carries out actions and contributes to the fight against AIDS, malaria and tuberculosis, which are the three major pandemics that the 2030 Agenda for Sustainable Development aims to eradicate. France was also behind one of the initiatives to combat COVID-19. In this framework, France is:

  • a founding member and the second-largest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, disbursing more than €5 billion since the Fund’s creation in 2002. In 2019, France hosted the Sixth Replenishment Conference in Lyon, during which $14.02 billion dollars was raised for the following three years.
  • the fifth-largest donor and champion of GAVI, the Vaccine Alliance which it has supported since 2004 to contribute to global vaccination efforts. Since GAVI was set up in 2000, 760 million children have been vaccinated and 13 million deaths avoided.
  • behind the partnership initiative Unitaid, which aims to find innovative ways to prevent, diagnose and treat HIV/AIDS, tuberculosis and malaria and their co-infections faster, more effectively and at a lesser cost in developing countries.

Tackling COVID-19

France was behind the launch of a global initiative to combat COVID-19. The Access to COVID-19 Tools (ACT) Accelerator or ACT-A, aims to accelerate the development and production of diagnostics, therapeutics and vaccines for COVID-19 and ensure equal access for all countries.

Political mobilization in favour of equitable and universal access to healthcare products to treat and prevent COVID-19 – which should be considered global public goods – is also crucial. To this end, France promoted a Charter for Equitable Access to COVID-19 Tools which was adopted on 9 February 2021 by the members of the ACT-A Facilitation Council.

To provide additional support to the poorest countries facing the crisis, France launched the “COVID-19 Health in Common” initiative on 9 April 2020.
With a budget of €1.15 billion (€150 million in grants and €1 billion in loans), this initiative implemented by the Agence Française de Développement (French Development Agency, AFD) provided effective support to health systems, regional epidemiological monitoring networks and NGOs in Africa, the Indian Ocean, the Caribbean and the Middle East.

Improving universal access to healthcare for women

As part of its feminist foreign policy, France advocates in favour of rights to sexual, reproductive, maternal, infant and adolescent health including the right to abortion.

One of the flagship programmes to improve the health of women, children and adolescents is the French Muskoka Fund, which operates in nine countries of Western and Central Africa (Benin, Burkina Faso, Chad, Côte d’Ivoire, Guinea, Mali, Niger, Senegal, and Togo).

Between 2011 and 2018, the work of this fund helped reduce infant and child mortality by 32% and maternal mortality by 17%.

In June 2021, France will host the Generation Equality Forum in Paris, to celebrate the 25th anniversary of the Beijing World Conference on Women. This event will provide another opportunity for the international community to pursue its commitment to women’s and girl’s rights to health and their right to control their own bodies.

Fostering a global coordinated response to health challenges

To build a coordinated response to global public health challenges, France supports the essential role played by the World Health Organization.
In 2020, it was involved in the creation of the WHO Academy. Located in Lyon and with France providing financing of €90 million, the Academy organizes professional development courses in healthcare, for 1 million people around the world (general public, leaders, teachers, researchers and healthcare workers, etc.).
By supporting WHO, France is helping to achieve the Triple Billion targets, which the organization has set for 2023:

  • One billion more people benefitting from universal health coverage;
  • One billion more people better protected from health emergencies;
  • One billion more people enjoying better health and well-being.
    Furthermore, France plays an important role in other international forums where healthcare matters are addressed: the European Union, the G7 and G20, and the Foreign Policy and Global Health Initiative.

Strengthening health systems to achieve universal health coverage

Today, almost one billion people live without access to basic health services, and more than 100 million people fall into poverty every year because of the cost of the healthcare they need. To respond to new global public health challenges and adapt to the changing international context and frameworks, France has adopted a cross-cutting approach that focuses on strengthening health systems. The aim is to achieve universal health coverage (UHC) to ensure access for all, including vulnerable and marginalized populations, to quality health services without risking financial difficulties. To maximise the advocacy in favour of UHC and coordinate efforts in favour of expanding it, France is a member of the UHC2030 coalition, a global movement that brings together States, international organizations and civil society, and the Providing for Health (P4H) network, which brings together major global stakeholders in health financing and their experts.

Ensure international health security

France is helping redesign the international health security architecture, making the World Health Organization its guarantor.

France’s commitment in figures

• More than €500 million per year allocated to multilateral funds (Global Fund, GAVI, Unitaid)
• More than €5 billion disbursed for the Global Fund to Fight AIDS, Tuberculosis and Malaria
• More than €1.7 billion disbursed (to date) for Unitaid, agency for innovation in global health
• €465 million (for the 2016-2020 period) donated to GAVI, the Vaccine Alliance
• More than €110 million invested in the French Muskoka Fund for sexual, reproductive, maternal, neonatal, infant and adolescent health
• €574 million invested by the Agence Française de Développement (AFD) in healthcare and social protection in 2019
• More than €500 million for the ACT-A Accelerator
• €1.2 billion to respond to the COVID-19 health crisis in the most vulnerable countries

Who are the field actors of this mobilization?

The Ministry for Europe and Foreign Affairs (MEAE) has the technical and human resources to work in the field of global public health.
Two MEAE agencies implement French expertise and official development assistance policy in the field of health around the world.

The Agence Française de Développement (AFD) takes care of the financing of development policies and projects. It acts as a donor in 90 countries, providing grants (in the form of debt relief and development contracts, or C2Ds), sovereign loans (to States), non-sovereign loans (to public entities without state guarantees) and private loans (in support of the profit and non-profit private sector). Its [health and social protection>] and [civil society organizations-] divisions are major players in global public health;
• The French agency for international technical cooperation, Expertise France, leverages French public expertise. It develops and implements public health projects dedicated to the three major pandemics (HIV/AIDS, tuberculosis and malaria) thanks to the Initiative, and aims to strengthen health systems to achieve universal health coverage and health security.

A specialized network within embassies of ten regional advisers in global public health present in sub-Saharan Africa, the Middle East and South-East Asia monitor the actions of the Global Fund, Unitaid and GAVI, the Vaccine Alliance and the French Muskoka Fund, and keep watch over global public health issues.

Updated: February 2021

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